LAUSR

OBJECTIVE This study evaluates outcomes of comparable pseudophakic rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV-SB). DESIGN Multicenter, retrospective, interventional cohort study. Subjects, Participants, and/or Controls: Data were gathered from patients from multiple retina practices in the United States with RRD in 2015. Methods, Intervention, or Testing: A large detailed database was generated. Pseudophakic patients with RRD managed with PPV or PPV-SB were analyzed for anatomic and visual outcomes. Eyes with proliferative vitreoretinopathy (PVR), giant retinal tears, previous invasive glaucoma surgery, and < 90 days of follow-up were excluded from outcomes analysis. Single surgery anatomic success (SSAS) was defined as retinal attachment without ongoing tamponade and with no other RRD surgery within 90 days. MAIN OUTCOME MEASURES SSAS and final Snellen visual acuity (VA). RESULTS 1158 out of 2620 eyes (44%) with primary RRD were pseudophakic. A total of 1018 eyes had greater than 90 days of follow-up. Eyes with PVR, previous glaucoma surgery, and giant retinal tears were excluded, leaving 893 pseudophakic eyes eligible for outcome analysis. 461 (52%) were right eyes. 606 patients (67%) were male, with a mean age of 65 ±11 years. PPV or PPV-SB as the first procedure were performed on 684 (77%) and 209 (23%) eyes, respectively. The mean follow-up was 388 + 161 days, and overall SSAS was achieved in 770 (86%) eyes. SSAS was 84% (577/684) for PPV, and 92% (193/209) for PPV-SB. The difference in SSAS between types of treatment was significant (p=0.009). In eyes with macula-on RRD, SSAS was 88% in eyes treated with PPV, and 100% in eyes treated with PPV-SB (p=0.0088). In eyes with macula-off RRD, SSAS was 81% in eyes treated with PPV and 89% in eyes treated with PPV-SB (p=0.029). SSAS was greater for PPV-SB than PPV for inferior (96% vs 82%) and superior (92% vs 82%) detachments. Mean final VA was similar for PPV (20/47) and PPV-SB (20/46; p=0.805). CONCLUSION In pseudophakic RRDs, SSAS was better in patients treated with PPV-SB compared to PPV alone while visual outcomes were similar for both groups.